| NPI | 1720766728 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACEE JOY BARTLEY Administrator, Operator 620-290-3936 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2023-07-10 |
| Last Update Date | 2023-07-10 |